Trends in Prostate Brachytherapy Utilization in the United States and Implications for Resident Training

IF 3.5 3区医学 Q2 ONCOLOGY

Practical Radiation Oncology Pub Date : 2026-05-01 Epub Date: 2025-11-04 DOI:10.1016/j.prro.2025.10.004

Evrosina I. Isaac MD , Mustafa Basree DO, MS , Peter F. Orio III DO, MS , Catheryn M. Yashar MD , Mitchell Kamrava MD

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引用次数: 0

Abstract

Purpose

Although there is substantial evidence for prostate brachytherapy as an effective and efficient treatment option as monotherapy or part of multimodality regimens, brachytherapy numbers have decreased over the last decade. The purpose of this analysis is to describe prostate brachytherapy trends from 2013 to 2022 and its relationship with resident brachytherapy training.

Methods and Materials

The Medicare Provider and Other Supplier Public Use File database was searched by provider and state for code 55875 (transperineal placement of needles or catheters into prostate for interstitial radio element application, with or without cystoscopy) for years 2013 to 2022. The top 10 states (and providers/organizations) for total contributions to nationwide total of providers and services were determined. Resident brachytherapy case log information was accessed from the Accreditation Council for Graduate Medical Education and included data until 2023/2024.

Results

Between 2013 and 2022, there was a 50% decrease in total providers, 30% decrease in patients, and 32% decrease in services. Thirty-eight states had decreases in providers and 32 had decreases in services. There were 15 states in the top 10 for providers and 14 states in the top 10 for services for at least 1 year during this period and had a significant contribution to both providers (62%) and services (66%). Highest volume providers were likely to be in private versus academic practices. Meanwhile, residents had a decrease in median low-dose-rate cases between 2017/2018 and 2023/2024 of 4 to 1 and in high dose rate, an increase from 0 to 1.

Conclusions

While there is significant evidence for the use of prostate brachytherapy in many treatment settings, there has been a decrease in the number of practicing providers and the number of patients treated over the last decade. With private practices contributing significantly to services provided, this may be partially responsible to low resident cases being logged. This highlights the need to improve resident training opportunities in academic centers.

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前列腺近距离放射治疗在美国的应用趋势及其对住院医师培训的影响：前列腺近距离放射治疗和住院医师培训。

背景：尽管有大量证据表明前列腺近距离放射治疗作为单一治疗或多模式治疗方案的一部分是有效和高效的治疗选择，但近距离放射治疗的数量在过去十年中有所减少。本分析的目的是描述2013-2022年前列腺近距离治疗趋势及其与住院医师近距离治疗培训的关系。方法：在2013-2022年医疗保险提供者和其他提供者公共使用文件数据库中，由提供者和州检索代码55875（经会阴置针或导管进入前列腺用于间质放射性元素应用，伴或不伴膀胱镜检查）。确定了对全国供应商和服务总数贡献最大的10个州（和供应商/组织）。从ACGME访问住院近距离治疗病例日志信息，包括截至2023/2024年的数据。结果：2013-2022年间，医疗服务提供者总数减少50%，患者减少30%，服务减少32%。38个州的供应商减少，32个州的服务减少。在此期间，有15个州在供应商前十名中，14个州在服务前十名中至少有一年，并且对供应商（62%）和服务（66%）都有重大贡献。业务量最大的供应商可能是私人企业，而不是学术企业。与此同时，从2017/18年到2023/24年，居民LDR病例中位数从4比1下降到1，HDR中位数从0增加到1。结论：虽然有明显的证据表明前列腺近距离放射治疗在许多治疗环境中使用，但在过去十年中，执业提供者的数量和接受治疗的患者数量都有所减少。由于私人诊所对所提供的服务贡献巨大，这可能部分负责低住院病例记录。这凸显了提高学术中心住院医师培训机会的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Practical Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.20

自引率

6.10%

发文量

177

审稿时长

34 days

期刊介绍： The overarching mission of Practical Radiation Oncology is to improve the quality of radiation oncology practice. PRO''s purpose is to document the state of current practice, providing background for those in training and continuing education for practitioners, through discussion and illustration of new techniques, evaluation of current practices, and publication of case reports. PRO strives to provide its readers content that emphasizes knowledge "with a purpose." The content of PRO includes: Original articles focusing on patient safety, quality measurement, or quality improvement initiatives Original articles focusing on imaging, contouring, target delineation, simulation, treatment planning, immobilization, organ motion, and other practical issues ASTRO guidelines, position papers, and consensus statements Essays that highlight enriching personal experiences in caring for cancer patients and their families.